Quantitative Assessment of Breast Cosmetic Outcome After Whole-Breast Irradiation.

Autor:	Reddy JP; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Lei X; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas., Huang SC; Department of Biomedical Engineering, University of Texas, Austin, Texas., Nicklaus KM; Department of Biomedical Engineering, University of Texas, Austin, Texas., Fingeret MC; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas., Shaitelman SF; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Hunt KK; Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Buchholz TA; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Merchant F; Department of Engineering Technology, University of Houston, Houston, Texas., Markey MK; Department of Biomedical Engineering, University of Texas, Austin, Texas; Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas., Smith BD; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: bsmith3@mdanderson.org.
Jazyk:	angličtina
Zdroj:	International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2017 Apr 01; Vol. 97 (5), pp. 894-902. Date of Electronic Publication: 2016 Dec 21.
DOI:	10.1016/j.ijrobp.2016.12.021
Abstrakt:	Purpose: To measure, by quantitative analysis of digital photographs, breast cosmetic outcome within the setting of a randomized trial of conventionally fractionated (CF) and hypofractionated (HF) whole-breast irradiation (WBI), to identify how quantitative cosmesis metrics were associated with patient- and physician-reported cosmesis and whether they differed by treatment arm. Methods and Materials: From 2011 to 2014, 287 women aged ≥40 with ductal carcinoma in situ or early invasive breast cancer were randomized to HF-WBI (42.56 Gy/16 fractions [fx] + 10-12.5 Gy/4-5 fx boost) or CF-WBI (50 Gy/25 fx + 10-14 Gy/5-7 fx). At 1 year after treatment we collected digital photographs, patient-reported cosmesis using the Breast Cancer Treatment and Outcomes Scale, and physician-reported cosmesis using the Radiation Therapy Oncology Group scale. Six quantitative measures of breast symmetry, labeled M1-M6, were calculated from anteroposterior digital photographs. For each measure, values closer to 1 imply greater symmetry, and values closer to 0 imply greater asymmetry. Associations between M1-M6 and patient- and physician-reported cosmesis and treatment arm were evaluated using the Kruskal-Wallis test. Results: Among 245 evaluable patients, patient-reported cosmesis was strongly associated with M1 (vertical symmetry measure) (P<.01). Physician-reported cosmesis was similarly correlated with M1 (P<.01) and also with M2 (vertical symmetry, P=.01) and M4 (horizontal symmetry, P=.03). At 1 year after treatment, HF-WBI resulted in better values of M2 (P=.02) and M3 (P<.01) than CF-WBI; treatment arm was not significantly associated with M1, M4, M5, or M6 (P≥.12). Conclusions: Quantitative assessment of breast photographs reveals similar to improved cosmetic outcome with HF-WBI compared with CF-WBI 1 year after treatment. Assessing cosmetic outcome using these measures could be useful for future comparative effectiveness studies and outcome reporting. (Copyright © 2016 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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